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The author has disclosed no potential conflicts of interest, financial or otherwise.
Eighteen years ago, an alarming report on preventable deaths from medical errors was released by the Institute of Medicine ( IOM, 2000 ). That report featured the estimate that approximately 100,000 people in the United States die each year because of preventable medical errors. A subsequent IOM report ( 2003 ) called for all health professionals to be better prepared to keep patients safe, focusing on five core competencies for health professions education: patient-centered care, interprofessional collaboration, evidence-based practice, quality improvement, and informatics.
Visionary leaders in nursing education were ahead of the curve, responding to the call for safer and more effective care via the Quality and Safety Education for Nurses (QSEN) project ( Cronenwett et al., 2007 ). In 2008, the Institute for Healthcare Improvement announced a major initiative-the Triple Aim-which focuses on "simultaneous pursuit of three aims: improving the experience of care, improving the health of populations, and reducing per capita costs of health care" ( Berwick, Nolan, & Whittington, 2008 , p. 759). Subsequently, Bodenheimer and Sinsky ( 2014 ) proposed a fourth-a quadruple-aim to improve the work life of health care providers, both clinicians and staff.
What progress has been made during the past 19 years since the IOM report, with 10 years of QSEN education, and 9 years after the Triple Aim was launched? Improvements in some health outcomes have been reported. For instance, the United States has seen a 15% reduction in infant mortality rates compared with 2005 ( Kochanek, Murphy, Xu, & Tejada-Vera, 2014 ). Numbers of hospital-acquired conditions, such as central line-associated bloodstream infections (CLABSIs), pressure ulcers, and falls with injuries have significantly decreased from 2010 to 2013, according to a recent report from the American Hospital Association ( 2015 ). However, in terms of better care and lower costs, we are not yet there. James ( 2013 ) has estimated annual hospital patient deaths due to preventable harm to be over 400,000 per year. Reports from consumers of health care continue to include stories of poor care experiences, including lack of compassion and frustrations in navigating the complexities of the care...